Stein B A, Elliott K C, McKeough M J
Can J Psychiatry. 1982 Jun;27(4):301-6. doi: 10.1177/070674378202700407.
Clinicians are reluctant to diagnose severe mental disturbances in adolescents. The psychoanalytic literature on adolescent turmoil has de-emphasized the phenomenology of the clinical picture leading to diagnostic difficulties. Several studies have shown that symptomatic adolescents for the most part continue to demonstrate disturbances in adulthood. This paper reports on the population of adolescents admitted to an inpatient unit and compares it with a population admitted three years earlier. There was an increase in the number of referrals indicating a greater demand for service by the community. The patient population showed a significant trend toward more serious psychiatric disturbance, psychoses and personality disorders, with far fewer adjustment reactions. There was also a great increase in the number of re-admissions which again reflects severity of illness. Antidepressants continue to be infrequently used. Major tranquilizers were used less frequently and with greater specificity in both psychoses and personality disorders. Major implications for identifying and treating recurrent psychiatric illnesses in adolescents are discussed.
临床医生不愿诊断青少年的严重精神障碍。关于青少年动荡的精神分析文献淡化了临床表现的现象学，导致诊断困难。几项研究表明，有症状的青少年在很大程度上在成年后仍表现出精神障碍。本文报告了入住住院部的青少年群体，并将其与三年前入院的群体进行了比较。转诊数量有所增加，表明社区对服务的需求更大。患者群体呈现出一种明显的趋势，即出现更严重的精神障碍、精神病和人格障碍，而适应反应则少得多。再次入院的人数也大幅增加，这再次反映了疾病的严重程度。抗抑郁药的使用仍然很少。在精神病和人格障碍中，主要镇静剂的使用频率较低且针对性更强。文中讨论了识别和治疗青少年复发性精神疾病的主要意义。
